Monday, December 9, 2013

Beating Back the Devil

Beating Back the Devil: On the Front Lines with the Disease Detectives of the Epidemic Intelligence ServiceBeating Back the Devil: On the Front Lines with the Disease Detectives of the Epidemic Intelligence Service by Maryn McKenna
My rating: 3 of 5 stars

The Center for Disease Control has been on the front lines fighting the effects of war, terrorism, and disease since 1946; this book recounts many of their most important cases.

Beating Back the Devil reads like a collection of true crime stories, rarely pausing to parse its technical terms or explain some of the statistical methods of epidemiologists, but galloping into the mystery of disease.

Tracking a small group of disease detectives in the Epidemic Intelligence Service's (EIS) class of 2002, the case histories range from the successful international efforts to eradicate smallpox, the spread of AIDS-related infections in minority drag queen communities, fighting cholera in Rwandan refugee camps, to tracking the post-9/11 anthrax letters.

There are surprising details here - for example, the U.S. government has a uniformed Commissioned Corps that has a military structure (to which the civilian doctors of the EIS struggle to conform).

My favorite chapter recounts the mystery of how West Nile virus contaminated donated organs, and it hints at the incredible amount of legwork required to come close to controlling an outbreak. There is also an interesting account of organizing a study of pregnant women in Malawi to fight malaria, and the story of efforts to prevent the spread of tuberculosis among the underground drag queens (whose extravagant balls are documented in the film Paris is Burning). The specter of AIDS looms large over many of the stories in the book, since AIDS victims' compromised immune systems are especially vulnerable to infection.

The chapter entitled "War" tells the surprising story of EIS efforts in refugee camps after the Rwandan genocide: CDC doctors made sure relief workers knew how to treat cholera patients and used their research skills to verify food distribution and make sure that women and children were not overlooked. The CDC doctors witnessed the continuation of horrors of genocide (many of the refugees were the perpetrators of the Rwandan genocide), the children without parents, and the privations of an overcrowded refugee camp.

For those interested in the history of disease, be sure to check out Rabid: A Cultural History of the World's Most Diabolical Virus by Bill Wasik and Monica Murphy. There is also a free CDC Solve the Outbreak app for iPad that will teach you the basics of epidemiology, and the CDC Zombie outbreak guide, which is a light-hearted take on disaster preparedness. For more from the front lines of the CDC, check out Level 4: Virus Hunters of the CDC by Joseph B. McCormick.

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